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DR. HERBERT S SU DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1265764351
Individual Registrant:DR. HERBERT S SU DDS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
9611 GARVEY AVE #124 S EL MONTE, CA 91733-1026 US
Tel: 626-448-2296 Fax: 626-448-2296
Tel: 626-448-2296 Fax: 626-448-2296
Contact information for business:
9611 GARVEY AVE #124 S EL MONTE, CA 91733-1026 US
Tel: 626-448-2296 Fax: 626-448-2296
Tel: 626-448-2296 Fax: 626-448-2296
Registration Information:
NPI: 1265764351
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | CA | DZ035034 |
| N | 122300000X | Dental Providers Dentist | CA | DZ035034 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
